Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Department of Disease Control and Prevention, Xi'an Children's Hospital, Xi'an, Shaanxi, China.
Vaccine. 2022 Jan 28;40(4):612-620. doi: 10.1016/j.vaccine.2021.12.020. Epub 2021 Dec 15.
COVID-19 vaccination needs a high population coverage to achieve herd immunity. We investigated prevalence of three scenarios of intention of free COVID-19 vaccination involving: 1) 80% effectiveness and rare and mild side effects (Scenario 1), 2) 50% effectiveness and rare and mild side effect RMSE (Scenario 2), and 3) immediate vaccination (Scenario 3), and their associated factors derived from the pre-intentional motivational phase of the Health Action Process Approach (HAPA).
A random population-based telephone survey interviewed 450 Chinese adults in the general population (September 16-30, 2020). The four HAPA constructs included a) risk perception scale, b) overall scale/four subscales of positive outcome expectancy of COVID-19 vaccination, c) overall scale/three subscales of negative outcome expectancy of COVID-19 vaccination, and d) the overall scale/two subscales of self-efficacy of COVID-19 vaccination.
The prevalence of intention of COVID-19 vaccination under Scenarios 1 to 3 was 38.0%, 11.1%, and 13.1%, respectively. Logistic regression analyses adjusted for background factors showed that 1) the associations between risk perception and the three scenarios of intention were non-significant; 2) the overall scale/four subscales of positive outcome expectancy were in general positively associated with two scenarios of intention (80% effectiveness and immediate vaccination); 3) the overall scale/three subscales of negative outcome expectancy were in general negatively associated with all three scenarios of intention; 4) the overall scale/two subscales of self-efficacy were only positively associated with the intention that involved 80% effectiveness. When all the four overall scales were entered into an adjusted model, positive and negative outcome expectancy, but not risk perception and self-efficacy, were independently associated with the three scenarios.
In this study population, the prevalence of intention of COVID-19 vaccination was very low and might not result in population protection. Health promotion should modify outcome expectancies to increase intention of COVID-19 vaccination.
实现群体免疫，新冠疫苗接种需要高人群覆盖率。我们调查了三种意愿方案下接种新冠疫苗的流行率，这三种方案涉及：1）有效性为 80%，且副作用罕见且轻微（方案 1）；2）有效性为 50%，且副作用罕见且轻微（方案 2）；3）立即接种（方案 3），并基于健康行动过程方法（HAPA）的前意向动机阶段得出其相关因素。
2020 年 9 月 16 日至 30 日，通过随机人群基础电话调查采访了 450 名中国普通人群中的成年人。HAPA 的四个构建包括：a）风险感知量表；b）新冠疫苗接种的正向预期总量表/四个分量表；c）新冠疫苗接种的负向预期总量表/三个分量表；d）新冠疫苗接种的自我效能总量表/两个分量表。
方案 1 至 3 下的新冠疫苗接种意愿流行率分别为 38.0%、11.1%和 13.1%。调整背景因素的逻辑回归分析表明，1）风险感知与三种意愿方案之间的关联不显著；2）正向预期的总量表/四个分量表普遍与两种意愿方案（80%有效性和立即接种）呈正相关；3）负向预期的总量表/三个分量表普遍与三种意愿方案均呈负相关；4）自我效能的总量表/两个分量表仅与涉及 80%有效性的意愿方案呈正相关。当将四个总量表全部纳入调整模型时，只有正、负向预期与三种意愿方案相关，而风险感知和自我效能则不相关。
在本研究人群中，新冠疫苗接种意愿的流行率非常低，可能无法实现人群保护。健康促进应改变预期结果，以增加新冠疫苗接种意愿。
